Complications of local corticosteroid injections

Area of Science:

• Rheumatology
• Orthopedics
• Dermatology

Background:

• Corticosteroid injections are commonly used to manage rheumatic disorders.
• Local administration aims to reduce systemic side effects while providing targeted relief.

Observation:

• Four patients with rheumatic conditions experienced unusual complications after local corticosteroid injections.
• Complications varied, including tendon ruptures, digital deformities, and infections.

Findings:

• Bilateral digital flexor tendon rupture occurred after carpal tunnel injection for median nerve compression.
• Bowstring deformity followed digital flexor tendonitis treatment.
• Carpal tunnel infection arose post-wrist arthrocentesis in rheumatoid arthritis.
• Facial, neck, and chest flushing was noted after intrasynovial injection for psoriatic arthritis.

Implications:

• These cases highlight potential, albeit rare, adverse effects of local corticosteroid therapy.
• Understanding corticosteroid physiology is crucial for predicting and mitigating these untoward events.
• Clinicians should be aware of these risks when administering corticosteroid injections for rheumatic diseases.